For those unfamiliar with liens, they might be the best alternative if you’ve been involved in a personal injury matter.
Being treated on a lien basis means medical providers will agree to provide and render medical services with no requirement of payment upfront, either on a cash basis or through insurance. Providers bill and both attorney and client must sign a lien agreement; basically, a contract promising to pay from any settlement proceeds to pay for the doctor’s treatment bills.
Many people are treated on a lien basis because they don’t have insurance, or don’t want to use their existing insurance. Not only do they often not have insurance, but in cases where people do, it might be an HMO, Medical, or Medicare, which restrict you from seeing certain providers. This makes the process a lot more cumbersome, restrictive, and unnecessarily time-consuming. With an HMO or even Medical, you need to go to your primary care physician first and get a referral to see a specialist, taking significant time and effort. Adamson Ahdoot LLP could help you get to a lien specialist, maybe even a neurosurgeon, pain management specialist, or neurologist within a day, with no requirement of a referral from a primary care physician.
80 to 90% of Adamson Ahdoot clients are using a lien-based medical treatment because of lack of their own insurance or not having extensive enough insurance. Usually, the only insurance that is sufficient for proper medical care is a PPO. However, PPOs are expensive and cost-prohibitive for most people, including most clients which Adamson Ahdoot represents. While we have clients that have PPO coverage, in those instances, it might make sense for them to treat on their own insurance. But even in those instances, we have clients that prefer not to use their insurance to seek treatment because there are still providers that might be outside of their network.
One important thing to remember is not only is Adamson Ahdoot helping people make sure they get the right medical treatment but helping retain providers that know how to work in a forensic environment. [These providers] know how to write reports insurance companies will understand and help maximize the value of the case. And if necessary, know how to testify in order to fully protect the client’s needs in litigation when they are deposed. Their strength lies in the ability to convey the nature and extent of our client’s injuries accurately and articulately, along with their treatment and the damages associated there.
The goal of a forensic evaluation in a personal injury case is to do a pre/post-injury comparison to examine the impact of an event on a person’s functioning and how this will impact them in the future.Emin Gharibian, Psy.D. – Founder and Director – Verdugo Psychological Associates
Statutory and Contractual liens. A contractual lien is when the client and their attorney both sign an agreement to pay from a settlement. But in California, sometimes emergency medical services are rendered by a hospital and there’s no time for the client to sign a lien. Often, at that point, the client won’t have an attorney. The State of California has enacted legislation that allows certain providers, namely hospitals, to assert what’s called a statutory lien on any potential settlement proceeds which a claimant might be entitled to as a result of someone else’s negligence.
The term statutory lien is pretty narrow in scope. Really just meant for hospitals for rendering emergency services, there’s a specific definition of who is entitled to a statutory lien in California. Additionally, there are specific requirements on how liens must be perfected. As an example, issuers must send certified mail to the attorney. There are very strict requirements on who is entitled to a statutory lien and how to perfect them.
A perfected lien is one that has been filed with the appropriate filing agent for the creditor to legally secure assets.
Every provider can have their own agreement, but they’re generally the same, “We promise to pay the provider back from the settlement proceeds.”
Lien repayment is calculated from a client’s accrued bills. Most, but not all providers are usually willing to negotiate with their billing amount once Adamson Ahdoot has settled their case.
There are a few reasons to seek treatment on a lien basis. Clients get access to more providers they normally wouldn’t have. A lien basis also doesn’t require cash or insurance upfront. Clients also have access to providers that are comfortable and have the know-how to provide reports in a forensic environment.
No. Most providers won’t provide services on a lien without an attorney they trust involved. Their only assurance of being paid and being paid fairly, is the attorney who’s ultimately going to have control of the settlement proceeds.
Adamson Ahdoot LLP informs our clients of the option of utilizing a lien provider. We also provide different options of lead providers in their area which would be beneficial to use based on the nature and extent of their injuries. These are part of the services rendered to the client.
Med Pay is coverage that an insurance company provides to pay out for medical services irrespective of liability. Consider the following example: You go to Walmart, fall, get hurt, and require medical services. If Walmart has a $5,000 Med Pay policy, the insurance company that provides insurance for Walmart will pay $5,000 for medical bills if accrued regardless of whether or not they were legally liable. Even if the client slips on their own accord, Med Pay will pay up to $5,000 irrespective of liability.
If a health insurance company pays for medical services that our client ends up getting reimbursed from a third party, the health insurance company will seek reimbursement and they will try to assert a lien on the settlement proceeds for that right of reimbursement.
An example would be getting rear-ended and going to the hospital. Upon entering, you would give the hospital your health insurance for them to pay for services rendered. Upon getting billed $500, your health insurance pays $250 for said services. Afterward, as part of your settlement, you receive reimbursement for your hospital bill. The insurance company will expect to get reimbursed as you’re not the one that paid for services. Your health insurance did. Med Pay subrogation exists when your own insurance company comes to collect monies a third-party paid.
This very rarely happens. In the extreme case it does, a client is technically still responsible for their medical bills. However, because we’ve nurtured relationships with these doctors, the fact the client did not receive recovery is explained, and the provider is usually gracious enough to waive their bill.
Aside from having your own insurance or paying cash or credit upfront, liens seem to be the most practical alternative for clients involved in a personal injury claim. Aside from your insurance or medical liens, a private pre-settlement legal funding company like High Rise Financial, could also provide lien services.
If you have specific questions related to liens that weren’t covered here, it is always best to consult with an experienced attorney that can orient you about the best use of liens.